glipizide/metformin (Metaglip) (cont.)

Pharmacy Author:
Medical and Pharmacy Editor:

DRUG INTERACTIONS:

Drugs which cause blood glucose levels to increase may diminish the effectiveness of glipizide/metformin therapy. These drugs include thiazides and other diuretics, corticosteroids, phenothiazines, thyroid medications, estrogens, birth control pills, phenytoin (Dilantin), nicotinic acid, sympathomimetics, calcium channel blockers (CCBs), and isoniazid (Nydrazid).

Cimetidine (Tagamet), by decreasing the elimination of metformin from the body, can increase the amount of metformin in the blood by 40%. This may increase the frequency of side effects from metformin.

Alcohol consumption increases the effect of metformin on lactate production, increasing the risk of lactic acidosis.

Due to the risk of lactic acidosis, metformin containing products must be temporarily discontinued prior to the administration of radiopaque contrast dyes. Metformin should be held for at least 48 hours after contrast dye administration and should not be restarted until patient's kidney function returns back to normal.

Beta blockers may increase the blood glucose lowering actions of sulfonylureas. Cardio-selective beta blockers such as acebutolol (Sectral), atenolol (Tenormin), metoprolol (Lopressor or Toprol XL), and penbutolol (Levatol) may be safer than their nonselective counterparts.

Colesevelam (Welchol) may reduce blood levels of glipizide. Patients are advised to take glipizide 1 hour before or 4 hours after colesevelam administration to minimize the risk of their interaction.

Concomitant use of systemic antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), miconazole, and voriconazole (VFEND) with glipizide may cause hypoglycemia.

Medically Reviewed by a Doctor on 2/5/2015


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